Torticollis and hormones.

Is there any relationship between female hormones and cervical dystonia (torticollis)?  I receive Botox injections for torticollis but have noticed it is always worse before and after my menstral cycle. I was wondering if hormone replacement or birth control would help. I am 40 years old and also showing signs of other problems during this time as well (insomnia, joint pain and restlessness). Thank you for your help.

[CCF Neuro[P] MD, RPS]

Dear Gail:

Sorry to hear about your dystonia.  There is some thought that anxiety can make dystonia worse, and there can be added stress before and after menses.  But a direct correlation of menstral hormones and dystonia is something I have not heard about.  As far a treating dystonias with hormones, there has been no effect seen with hormone treatment.  Using hormones may help your menstral cycle but likely not your dystonia.  Botox is usually the most efficacious treatment, as most medicines do not work well.

Sincerely,

CCF Neuro MD